HomeMy WebLinkAboutX2021-1667 - Permit ApplicationForm Worksheet for Combo Building & Solar Permit A
.omm'I r Residential City of Newport Beach - Building Division Application
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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:ription of Work
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OWNER'S NAME
Owner's Address
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APPLICANT'S NAME
Suite No
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# Storiesr— # Units (if Res)ri
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State
Applicant's Address
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Applicant's E-mail Address
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--- I ArchiteWDesigner's Address First I Lic. No. F-
Architect/Designer's E-mail Address
City
State F-- Zip [' Telephone
ENGINEER'S NAME
Last
Engineer's Address First r------ Lic.
Engineer's E-mail Address
City I
State Zip
Telephone
CONTRACTOR'S NAME/COMPANY
Contractor's Address ''�� �� ClassFZ?
ff Contractor's E-mail Address
City I State
I Zip Telephoner ---
SETBACKS REAR SETBACKS FRONT
PERMIT NO. SETBACKS LEFT
� SETBACKS RIGHT
USE ZONE PLAN CHECK NO. �=
DEVELOPMENT NO PLAN CHECK FEES $ __